Elbardesy H, Anazor F, Mirza M, Aly M, Maatough A. Cemented versus uncemented stems for revision total hip replacement: A systematic review and meta-analysis. World J Orthop 2023; 14(8): 630-640 [PMID: 37662666 DOI: 10.5312/wjo.v14.i8.630]
Corresponding Author of This Article
Hany Elbardesy, FRSC, MBChB, MD, MSc, PhD, Doctor, Postdoctoral Fellow, Department of Trauma and Orthopaedics, University of Manitoba, Sherbrook St, Winnipeg MB R3T2N2, Manitoba, Canada. elbardeh@myumanitoba.ca
Research Domain of This Article
Orthopedics
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Aug 18, 2023; 14(8): 630-640 Published online Aug 18, 2023. doi: 10.5312/wjo.v14.i8.630
Cemented versus uncemented stems for revision total hip replacement: A systematic review and meta-analysis
Hany Elbardesy, Fitzgerald Anazor, Mohammad Mirza, Mohamed Aly, Annis Maatough
Hany Elbardesy, Department of Trauma and Orthopaedics, University of Manitoba, Winnipeg MB R3T2N2, Manitoba, Canada
Fitzgerald Anazor, Nottingham University Hospitals NHS Foundation Trust, Nottingham NG7 2UH, United Kingdom
Mohammad Mirza, Annis Maatough, Department of Trauma and Orthopaedics, East Kent University Hospitals NHS Foundation Trust, Ashford TN240LY, Kent, United Kingdom
Mohamed Aly, Department of Trauma and Orthopaedics, Royal National Orthopaedic Hospital, London HA7 4LP, United Kingdom
Author contributions: Elbardesy H and Anazor F involved in the conceptualization of the study and data interpretation; Elbardesy H, Anazor F, and Mirza M contributed to the data analysis; Elbardesy H, Anazor F, and Aly M contributed to the study design; Elbardesy H, Anazor F, and Maatough A involved in the selection and screening of studies; Elbardesy H, Anazor F, Mirza M, Aly M, and Maatough A contributed to the manuscript preparation-writing and editing; and all authors read and approved the final draft of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hany Elbardesy, FRSC, MBChB, MD, MSc, PhD, Doctor, Postdoctoral Fellow, Department of Trauma and Orthopaedics, University of Manitoba, Sherbrook St, Winnipeg MB R3T2N2, Manitoba, Canada. elbardeh@myumanitoba.ca
Received: March 4, 2023 Peer-review started: March 4, 2023 First decision: June 14, 2023 Revised: June 20, 2023 Accepted: July 17, 2023 Article in press: July 17, 2023 Published online: August 18, 2023 Processing time: 165 Days and 13 Hours
Abstract
BACKGROUND
The popularity of uncemented stems in revision total hip arthroplasty (THA) has increased in the last decade.
AIM
To assess the outcomes of both cemented and uncemented stems after mid-term follow up.
METHODS
This study was performed following both the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement and the Cochrane Handbook for systematic reviews and meta-analysis guidelines. Articles were chosen irrespective of country of origin or language utilized for the article full texts. This paper included studies that reviewed revision THA for both cemented or uncemented long stems.
RESULTS
Three eligible studies were included in the meta-analysis. Analysis was conducted by using Review Manager version 5.3. We computed the risk ratio as a measure of the treatment effect, taking into account heterogeneity. We used random-effect models. There were no significant differences found for intraoperative periprosthetic fractures [risk ratio (RR) = 1.25; 95% confidence interval (CI): 0.29-5.32; P = 0.76], aseptic loosening (RR = 2.15, 95%CI: 0.81-5.70; P = 0.13), dislocation rate (RR = 0.50; 95%CI: 0.10-2.47; P = 0.39), or infection rate (RR = 0.99, 95%CI: 0.82-1.19; P = 0.89), between the uncemented and the cemented long stems for revision THA after mid-term follow-up.
CONCLUSION
This study has evaluated the mid-term outcomes of both cemented and uncemented stems at first-time revision THA. In summary, there were no significant differences in the dislocation rate, aseptic loosening, intraoperative periprosthetic fracture and infection rate between the two cohorts.
Core Tip: This paper included a meta-analysis of three studies involving 7600 revision total hip replacements, of which 3050 were performed using cemented stems, while 2539 were performed utilising uncemented stems. Based on the evidence from this study, there are no statistically significant differences in the rates for intraoperative periprosthetic fractures, aseptic loosening, dislocation and periprosthetic joint infection, for the cemented and uncemented long stems in revision total hip arthroplasty. Nevertheless, there was significant heterogeneity in the included studies for periprosthetic fractures, aseptic loosening and dislocation.
